Tissue-engineered mucosa graft for reconstruction of the intraoral lining after freeing of the tongue: A clinical and immunohistologic study
Tissue-engineered mucosa graft for reconstruction of the intraoral lining after freeing of the tongue: A clinical and immunohistologic study
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DOI：
10.1053/joms.2001.20489
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发表时间：
2001-02-01
影响因子：
1.9
通讯作者：
Schimming, R
中科院分区：
文献类型：
--
作者：
Lauer, G;Schimming, R
目的：本文描述了在口腔鳞状细胞癌切除后早期创面闭合的患者中，用组织工程黏膜移植物代替中厚皮肤移植物的方法。患者和方法：从6例患者的硬腭活检标本中培养出大小达75 cm(2)的组织工程黏膜移植物，从手术前3~4周开始。结果：5例患者舌面形成良好的舌槽沟，舌体活动良好，义齿支撑面满意。1例创面愈合障碍，导致舌槽沟严重萎缩，舌头活动度改善非常有限。术前溴脱氧尿嘧啶核苷(BrdU)标记移植物，术后应用抗BrdU抗体的移植区活检标本的免疫组织化学染色显示，培养的细胞已整合到新形成的粘膜上皮中。术后组织学检查显示移植黏膜上皮有分化过程，细胞角蛋白表达发生改变。术后6个月可恢复正常非移植黏膜的典型形态。结论：本研究为组织工程黏膜细胞移植修复口腔大面积创面提供了依据。完整的口腔内衬里迅速重建，在术后6个月内，移植物区域可见正常的上皮分化。(C)2001年美国口腔和颌面外科医生协会。
Purpose: This article describes the use of tissue-engineered mucosal grafts instead of split-thickness skin grafts after freeing of the tongue in patients who had previous resection of an oral squamous cell carcinoma and initial primary wound closure.Patients and Methods: Tissue-engineered mucosal grafts, up to 75 cm(2) in size, were cultured from biopsy specimens of the hard palate in 6 patients, starting 3 to 4 weeks before the operation. After freeing of the tongue, the engineered mucosa was implanted on the wound surface by using vaseline gauze as carrier and fixed with an intraoral gauze wound dressing.Results: A good glossoalveolar sulcus was formed in 5 patients, resulting in good mobility of the tongue and a satisfactory denture-bearing surface. In 1 patient, there was a disturbance of wound healing, leading to severe shrinkage of the glossoalveolar sulcus and very limited improvement in tongue mobility. Preoperative bromodeoxyuridine (BrdU) labeling of the graft and postoperative immunohistochemical staining of biopsy specimens from the grafted areas with anti-BrdU showed that the cultured cells are integrated into the newly formed mucosal epithelium. Postoperative histologic investigations showed a differentiation process in the grafted mucosal epithelium, with a change in the expression of cytokeratins. At 6 months postoperatively, the typical pattern of normal nongrafted mucosa was regained.Conclusions: This in investigation provides evidence that tissue-engineered mucosal cells can serve as a graft for large intraoral wounds. Complete intraoral lining is quickly reestablished, and normal epithelial differentiation is seen in the graft area within a 6-month postoperative period. (C) 2001 American Association of Oral and Maxillofacial Surgeons.